Efficacy of Imiquimod Cream Administered Intraperitoneally for Ovarian Metastases in Colorectal Cancer

Yi Hao Lin,Fu Chieh Chu,Hsiu Huei Peng

doi:10.4172/2161-0932.1000415

Abstract

In this case report, we sought to determine the efficacy of intraperitoneal Imiquimod cream for the treatment of persistent ovarian metastases in colorectal cancer after Avastin-based chemotherapy failure. Topical Imiquimod cream is an immune response modifier. It could trigger skin Langerhan cells (naive dendritic cells) as the priming responsive cell type and initiate a strong Th1-switched anti-tumor cellular immune response. This is a 50-year-old woman with rectal cancer with liver, lung, left adrenal gland and ovarian metastasis, and pelvic carcinomatosis. CEA level decreased after the initial optimal debulking surgery and 12 cycles of chemotherapy. However, CEA level persistently elevated, and CT scan showed progressed carcinomatosis, malignant ascites and diffused metastasis. After intraperitoneal immunomodulatory therapy (IMT) administration with intraperitoneal Interleukin-2 mix Thymoxin on Day 1, and intraperitoneal Imiquimod cream (5% 250 mg in normal saline 2 ml) on Day 2, the amount of drainage ascites gradually decreased, and CEA level dramatically decreased after IMT.

Highlights

Most existing vaccines and immunomodulatory adjuvants are administered via subcutaneous or intramuscular injection due to the consideration of drug safety
Topical Imiquimod cream (Trade name: Aldara 5% 250mg) is an immune response modifier, toll-like receptor 7 (TLR7) agonist for the treatment of anogenital warts proved by the US Food and Drug Administration [1]
We sought to determine the efficacy of intraperitoneal Imiquimod cream for the treatment of persistent ovarian metastases in colorectal cancer after failure of Avastin-based chemotherapy

Summary

Introduction

Most existing vaccines and immunomodulatory adjuvants are administered via subcutaneous or intramuscular injection due to the consideration of drug safety. The challenge of immunization is to provide vaccines that ensure enhancement of anti-cancer effects in elderly or immunocompromised patients. It could trigger skin Langerhan cells (naïve dendritic cells) as the priming responsive cell type and initiate a strong Th1-switched anti-tumor cellular immune response.

Results

Conclusion